pleural symphysis

No abstract text is available yet for this article.

No abstract text is available yet for this article.

STUDY OBJECTIVE: Many reports have shown that talc is the most effective and least expensive agent for the creation of a pleural symphysis. However, its use still remains controversial due to severe acute respiratory side effects possibly related to the systemic dissemination of talc particles. The purpose of this study was to assess the distribution of calibrated talc after intrapleural administration in rats. MATERIAL AMD METHODS: Thirty-seven Wistar male rats were randomly assigned to undergo pleurodesis by talc slurry (33 rats) or by simple chest tube drainage (control group; 4 rats)...

BACKGROUND: Transforming growth factor (TGF)-beta2 can produce effective pleurodesis in animals, but its efficacy has not been compared with commonly used pleurodesing agents in sheep, which have a thick pleura resembling that of humans. The acute physiological effects and the level of systemic TGF-beta absorption after its intrapleural administration have not been studied. The aims of the present study were to compare: (i) the effectiveness of TGF-beta2, talc and bleomycin in producing pleurodesis in sheep; (ii) the acute side-effects and systemic TGF-beta levels following the intrapleural administration of these agents; and (iii) histological changes after intrapleural injections of these agents...

STUDY OBJECTIVES: Intrapleural immunotherapy has shown some activity in patients with malignant mesothelioma. We conducted a multicentric pilot phase II study to evaluate the tolerance and the activity of intrapleurally infused autologous human activated macrophages (AM Phi) in patients with stage IA, IB, and IIA malignant pleural mesothelioma (MPM). DESIGN: AM Phi derived from in vitro monocyte culture were infused into the pleura of patients every week for 8 consecutive weeks...

UNLABELLED: PHYSIOLOGY: Chylothorax corresponds to the intrathoracic presence of chyle. Chyle is a lymph of intestinal origin containing the product of digested fat. This lymph joins the blood circulation through the thoracic duct. The thoracic duct receives a part of the lymphatic drainage from the viscera below the diaphragm, from the diaphragm and from the sterno-costal wall. PHYSIOPATHOLOGY: Intrapleural chyle issue is explained by an acquired or spontaneous lesion of the thoracic duct or of one of its collaterals in the thorax...

CHEMOTHERAPY: With regard to the efficacy of mono-chemotherapy and according to the literature, no cytotoxic substance, apart from methrotrexate at high doses, leads to a response rate of more than 20%. With regard to cyrotoxic associations, the published results show slightly betterresponse rates. IMMUNOTHERAPY: Interleukine 2 as well as various interferons have been tested alone or in association with chemotherapy. Fairly encouraging response rates have been reported...

INTRODUCTION: Catamenial pneumothorax occurs in women during the menses. It is frequently associated with diaphragmatic fenestrations or episodes of pleural endometriosis. OBSERVATION: We report the case of a patients who had presented 25 episodes of right pneumothorax despite treatment with videothorascopy initiated after the 10th episode. These episodes coincided with menstruation. Diagnosis of catamenial pneumothorax was evoked and thoracic surgery was indicated...

BACKGROUND: We have recently demonstrated that transforming growth factor beta-2 (TGF-beta2) can produce effective pleurodesis. Whether this effect can be reproduced by the use of its downstream proteins is not known. This study compared the effectiveness of TGF-beta2 and fibronectin in inducing pleurodesis in rabbits. METHODOLOGY: New Zealand white rabbits (1.5-2.0 kg) were given 1.7 microg of TGF-beta2 (n=5) or 2.0 mg of cellular fibronectin (n=4) intrapleurally via a chest tube...

BACKGROUND: Talc and tetracyclines induce pleurodesis by directly injuring the pleura. The injury results in intense inflammation which subsequently leads to fibrosis. Corticosteroids can inhibit talc pleurodesis by reducing the inflammatory process. We hypothesised that transforming growth factor beta2 (TGFbeta2), a fibrogenic cytokine with immunomodulatory functions, could induce effective pleurodesis without generating significant pleural inflammation and therefore remain effective despite co-administration of corticosteroids...

Talc is commonly given after drainage of the pleural space to create pleural symphysis. Recognized complications of pleural drainage followed by talc pleurodesis include reexpansion pulmonary edema, pneumonia, and adult respiratory distress syndrome. This report describes a complication of talc pleurodesis that appears not to have been appreciated previously. Chest radiographs obtained before and after talc pleurodesis were evaluated in a total of 108 patients in three groups; 89 of these patients were receiving palliative therapy for malignant pleural effusion...

Transforming growth factor-beta2 (TGF-beta2) has recently been shown to produce effective pleurodesis in rabbits. Conventional pleurodesing agents such as talc act by inducing pleural injury, which results in acute inflammation and fibrosis. TGF-beta2 is a profibrotic cytokine capable of producing fibrosis without inducing significant pleural inflammation. We hypothesize that intrapleural administration of TGF-beta2 would (1) produce an effective pleurodesis faster; (2) stimulate more collagen deposition, and (3) induce less inflammation when compared with intrapleural injection of talc...

BACKGROUND: We have recently shown that transforming growth factor (TGF)beta(2) induces effective pleurodesis in rabbits. However, rabbits have a thin pleura while humans have a thick visceral pleura. The effect of intrapleural administration of TGF beta(2) in animals with a thick pleura and its associated systemic effects have not been investigated. This study was undertaken (1) to develop a new animal model for the study of pleurodesis using sheep which have a thick pleura resembling that of humans; (2) to study the efficacy of TGF beta(2) as a pleurodesis agent in the sheep model; and (3) to assess whether histological changes occur in extrapulmonary organs after intrapleural administration of TGF beta(2)...

Management of refractory hepatic hydrothorax is a challenge to physicians in clinical practice. We reported two patients with hepatic hydrothorax, non-alcoholic cirrhosis and rapidly recurring pleural effusion. They failed to improve with diuretics and repeated thoracentesis. Refractory hepatic hydrothorax was successfully treated by minocycline-induced pleural symphysis. After pleurodesis, ventilatory function returned to normal in both patients. No recurrence of pleural effusion was noted. We suggest that minocycline pleurodesis is an alternative treatment for refractory hepatic hydrothorax because it is simple, safe and effective...

Mesothelioma is a rare disease but its incidence is rising. Diagnosis is still difficult but has been improved by immunohistochemical techniques and panels of pathologists. At the present time thoracoscopy is the most sensitive method for diagnosis of mesothelioma and a good alternative to thoracotomy. The main indication for thoracoscopy is unexplained pleurisy that cannot be diagnosed by needle biopsy. Thoracoscopy allows diagnosis in 95% of cases. Pleural ultrasound can be useful for diagnosis of limited pleurisy without multiple radiation exposure...

Surgical video thoracoscopy represents a new surgical approach to thoracic disease. Its objective is to limit thoracotomy trauma to the pleural wall and at the same time to eliminate the consequences of post-thoracotomy pain and post-operative respiratory dysfunction. There are certain indications which are already accepted as the gold standard, others still require validation and the inverse that certain interventions will probably be excluded from the domain of video thoracoscopy with acquired experience...

OBJECTIVE: To review our experience of video-assisted thoracoscopic surgery for the treatment of primary spontaneous pneumothorax. DESIGN: Longitudinal cohort study following up consecutive patients for 3 to 4.3 years. SETTING: Thoracic Surgery Department, Chest Diseases Hospital, Kuwait. PATIENTS AND INTERVENTION: Seventy-two consecutive patients undergoing thoracoscopy for primary spontaneous pneumothorax from January 1994 to June 1996...

OBJECTIVE: To study the pneumostatic ability of a collagen polymerised with a polysaccharide (GAO) glue in lung surgery; its influence in pleuro-pulmonary adhesion formation; the pulmonary tissue reaction to it, its biodegradability, and the eventual alterations of pulmonary compliance induced by the glue. METHODS: Two groups of ten rabbits (controls and treated) were operated under ventilatory assistance by thoracotomy to promote pleural adhesions, and injury to the lung...

BACKGROUND: It has been stated that thoracoscopic internal thoracic artery (ITA) mobilization is not recommended in the redo minimally invasive direct coronary artery bypass (MIDCAB) situation, presumably because adhesions from the previous coronary artery bypass grafting operation may preclude a thoracoscopic approach. However, there are advantages to thoracoscopic ITA mobilization in MIDCAB that could also be realized in the redo situation. METHODS: In 200 MIDCAB procedures over the last 3 and a half years, 11 patients, ages 49-83 (mean 69), were identified as having undergone an attempted ITA mobilization in a redo situation...

In November 1995, video-assisted minimally invasive direct coronary artery bypass procedure, which is defined as a combination of the thoracoscopic internal mammary artery (IMA) harvest and direct coronary bypass grafting, was introduced for patients who need minimally invasive direct coronary artery bypass (MIDCAB) using IMA. In the thoracoscopic IMA harvest, the pleural adhesions or symphysis present an obstacle. We present a case where a redo patient who had complete pleural symphysis of left chest cavity precluded the thoracoscopic IMA harvest, and MIDCAB with the H graft procedure was performed...